Overcrowding Factors in an Emergency Department: A Literature Review

The Emergency Department (ED) is an important department or unit and the core clinical unit of a hospital, which functions to receive, stabilize, and manage patients who need immediate emergency treatment, both in daily conditions and in disasters. Overcrowding in ED is a problem in many countries and is one cause of increased mortality and decreased quality of optimal health and nursing services in the world today, including in Indonesia. There has been little research on overcrowding factors in the ED. Many factors are thought to cause overcrowding. This literature review identifies factors that can influence overcrowding in the ED. The literature search was carried out on the electronic databases of Medline, PubMed, CINAHL, PsycInfo and the Cochrane Library with the keywords factors overcrowding, AND, ED crowding. The inclusion criteria consisted of overcrowding factors in the ED, Fulltext, and publishing from 2013 to 2019 in English. The assessment of the quality of the articles was carried out using instruments from CONSORT. The first search results found 5,026 articles, and after screening and evaluation, 3 articles met the inclusion criteria. The results of the literature review show that the many factors that influence the occurrence of overcrowding in the ED are categorized into three factors, namely input factors (increased number of patient visits), throughput factors (patient disposition and delay in diagnostic examination results), and output factors (access block, inability to transfer patients out of the emergency room to inpatient, lack of inpatient beds, entry rooms, and other resources).